Starting today, there's enough swine flu vaccine in the Houston area that providers are imposing fewer restrictions on who can get it.

Large shipments of H1N1 vaccine have made it into Texas over the past few days, arriving at health departments by the thousands of doses and eclipsing initial shipments — bundled by the hundreds — that trickled in earlier this month.

Until now, the state health department has steered vaccine to providers who treat pregnant women and toddlers. Health workers with direct patient contact also got early doses. Those people are part of priority groups identified by the federal Centers for Disease Control and Prevention this summer.

Pregnant women and small children are considered most at risk of complications from swine flu.

The city of Houston health department has more than 17,000 doses available today. Vaccinations begin at 9 a.m. at 10 city health clinics.

The doses are available on a first-come, first-served basis, though officials hope they go to high-risk patients, health department spokesman Porfirio Villarreal said. The 6,400 doses of injectable vaccine are reserved for pregnant women and those younger than 18 with underlying medical conditions.

The bulk of current H1N1 shipments has been the nasal spray form of the vaccine, which can be used by healthy, non-pregnant people between the ages of 2 to 49.

In the past three weeks, as many as 100,000 H1N1 vaccine doses have arrived in the Greater Houston area, Villarreal said.

More than 1,300 doses were given on Monday, spokeswoman Rita Obey said, and the pace continued Tuesday at five county clinics.

The H1N1 vaccine supply in Texas increased nearly fivefold as of last Wednesday, when 831,400 doses had been shipped to the state — compared with just 178,300 in the week before.

Most vaccinations free

As of Tuesday, 22.4 million doses of the vaccine were available nationwide, said Dr. Thomas Frieden, director of the CDC.

The agency expected to have at least 50 million doses on hand by the end of the month, including 3 million for Texas.

“We are all frustrated that we don't have more vaccine available now,” Frieden said.

If production goals are met, Texas will receive 15 million doses by mid-January.

The vaccine and associated supplies have been provided by the federal government, but some providers are charging to administer the vaccine.

Harris County officials are asking those who can pay to seek the vaccine from their doctor or another fee-based provider.

That will allow small children, their parents and pregnant women who cannot afford the roughly $20-per-dose fee to get free immunizations at public health clinics.

“We are focusing on them because historically that population is either uninsured or underinsured,” Obey said.

19 confirmed area deaths

On Tuesday, three more deaths were reported from complications of swine flu.

Galveston County revealed its first death Tuesday, a woman between 30 and 35 who died Oct. 20. A Fort Bend County man with “severe underlying medical conditions” died Oct. 22. And in Harris County, a male 10 to 18 years old died Oct. 18.

So far, 19 people have died from confirmed H1N1 complications in the Houston area, including 14 in Houston-Harris County.

CDC priority groups

A surprise 800 H1N1 doses arrived late Tuesday at the Montgomery County health department, which had used up its supply at a free drive-through clinic on Saturday.

“We are thrilled,” said spokeswoman Emily Llinas. “We are going to make appointments for people in the CDC priority groups.”

So what about healthy adults? And seniors?

Obey said those over 50 in Harris County who show up for the vaccine won't be turned away, but stressed that officials hope the current supply reaches pregnant women, small children and those in their households. So far, older people have the lowest rates of H1N1 hospitalization or death.

Since April, at least 95 people have died in Texas from swine flu. The toll includes at least 21 children.

The virus has sent more than 720 people to the hospital statewide, and 150 of those have ended up going into intensive care.